Journal of Surgery Concepts & Practice >

2025 , Vol. 30 >Issue 03: 223 - 227

DOI: https://doi.org/10.16139/j.1007-9610.2025.03.07

Original article

The relationship between blood glucose variability, disease severity and prognosis of the patients with acute pancreatitis

  • ZHU Shiyi ,
  • LU Tingting ,
  • XIE Rongli ,
  • TAN Dan ,
  • FEI Jian ,
  • CHEN Erzhen ,
  • CHEN Ying ,
  • XIA Yi
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  • 1a. Department of Emergency, b. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2. Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China

Received date: 2024-06-17

  Online published: 2025-09-01

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Abstract

Objective To explore the relationship between blood glucose variability, disease severity and prognosis of the patients with acute pancreatitis. Methods Total of 242 patients with acute pancreatitis admitted to the department of emergency from January 2019 to December 2019 were enrolled. The organ failure was evaluated according to Marshall's score, the severity of the disease was evaluated according to Atlanta's score, and the blood glucose indexes of three groups of patients with mild acute pancreatitis, moderate severe acute pancreatitis and severe acute pancreatitis were compared within seven days after admission. The relationship between blood glucose index and disease severity in different patients with acute pancreatitis was analyzed. Taking whether a puncture was performed at admission, whether the patient was admitted to the intensive care unit (ICU), and whether the patient died as endpoint events as classification factors, the relationship between blood glucose indicators and disease prognosis of patients with acute pancreatitis was analyzed using the One-Way ANOVA, Kruskal-Wallis test, Mann-Whitney U test, receiver operating characteristic curve (ROC curve), etc. Results Of the 242 patients, 70 cases (28.9%) were mild acute pancreatitis, 71 cases (29.3%) with moderate severe acute pancreatitis, 101 cases (41.7%) with severe acute pancreatitis. There was no statistically significant difference in the coefficient of variation of blood glucose among the three groups within 7 days of admission. The mean, standard deviation, maximum, minimum value and difference between maximum and minimum value of venous blood glucose in severe acute pancreatitis group were higher than those in moderate severe acute pancreatitis group, while those in moderate severe acute pancreatitis group were higher than those in mild acute pancreatitis group. The mean value of blood glucose of invasive operation group (IOP) (n=55) was higher than that of non-invasive operation (NOP) group(n=187). Conclusions The blood glucose level and fluctuation range of patients with acute pancreatitis within seven days after admission, are of great significance for the judgment of the severity and prognosis of the disease.

Key words： Mean value of venous blood glucose; Variability of venous blood glucose; Acute pancreatitis; Severity; Puncture

Cite this article

ZHU Shiyi , LU Tingting , XIE Rongli , TAN Dan , FEI Jian , CHEN Erzhen , CHEN Ying , XIA Yi . The relationship between blood glucose variability, disease severity and prognosis of the patients with acute pancreatitis[J]. Journal of Surgery Concepts & Practice, 2025 , 30(03) : 223 -227 . DOI: 10.16139/j.1007-9610.2025.03.07

References

[1] BANKS P A, BOLLEN T L, DERVENIS C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1):102-111.
[2] LEPP?NIEMI A, TOLONEN M, TARASCONI A, et al. Executive summary: WSES guidelines for the management of severe acute pancreatitis[J]. J Trauma Acute Care Surg, 2020, 88(6):888-890.
[3] FAGENHOLZ P J, CASTILLO C F, HARRIS N S, et al. Increasing United States hospital admissions for acute pancreatitis,1988-2003[J]. Ann Epidemiol, 2007, 17(7):491-497.
[4] MARSHALL J C, COOK D J, CHRISTOU N V, et al. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome[J]. Crit Care Med, 1995, 23(10):1638-1652.
[5] BOLLEN T L, SINGH V K, MAURER R, et al. A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis[J]. Am J Gastroenterol, 2012, 107(4):612-619.
[6] RANSON J H, RIFKIND K M, ROSES D F, et al. Prognostic signs and the role of operative management in acute pancreatitis[J]. Surg Gynecol Obstet, 1974, 139(1):69-81.
[7] BANKS P A, FREEMAN M L, Practice Parameters Committee of the American College of Gastroenterology, et al. Practice guidelines in acute pancreatitis[J]. Am J Gastroenterol, 2006, 101(10):2379-2400.
[8] BONE R C, BALK R A, CERRA F B, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine[J]. Chest, 1992, 101(6):1644-1655.
[9] BALTHAZAR E J, ROBINSON D L, MEGIBOW A J, et al. Acute pancreatitis: value of CT in establishing prognosis[J]. Radiology, 1990, 174(2):331-336.
[10] KRINSLEY J S. Glycemic variability: a strong independent predictor of mortality in critically ill patients[J]. Crit Care Med, 2008, 36(11):3008-3013.
[11] 康凌垲, 李小悦. 血糖变异度在急危重症患者预后中的作用研究进展[J]. 中华卫生应急电子杂志, 2021, 7(4):234-236.
  KANG L K, LI X Y. Progress in the effect of blood glucose variability on the prognosis of acute and critical patients[J]. Chin J Hyg Rescue(electronic edtion), 2021, 7(4):234-236.
[12] 郝俊杰, 孙贵新, 李昕, 等. 医学救援中常见内科急危重症的识别与处理[J]. 中华卫生应急电子杂志, 2018, 4(2):72-75.
  HAO J J, SUN G X, LI X, et al. Recognition and management of common internal medicine emergencies in medical rescue[J]. Chin J Hyg Rescue(electronic edtion), 2018, 4(2):72-75.
[13] 宋学梅, 曹猛, 项丽君, 等. 危重患者的血糖管理[J]. 临床荟萃, 2022, 37(1):66-71.
  SONG X M, CAO M, XIANG L J, et al. Glucose management in critically ill patients[J]. Clin Focus, 2022, 37(1):66-71.
[14] FORSMARK C E, VEGE S S, WILCOX C M. Acute pancreatitis[J]. N Engl J med, 2016, 375(20):1972-1981.
[15] 邵素花, 万娅莉, 林莉, 等. 急性胰腺炎患者应激性高血糖与免疫功能以及临床预后的关系研究[J]. 华南国防医学杂志, 2021, 35(4):262-265.
  SHAO S H, WAN Y L, LIN L, et al. Effects of stress hyperglycemia on immune dysfunction and clinical prognosis in acute pancreatitis patients[J]. Mil Med J South China, 2021, 35(4):262-265.
[16] ZUO Y Y, KANG Y, YIN W H, et al. The association of mean glucose level and glucose variability with intensive care unit mortality in patients with severe acute pancreatitis[J]. J Crit Care, 2012, 27(2):146-152.
[17] INGELS C, VANHOREBEEK I, VAN DEN BERGHE G, et al. Glucose homeostasis, nutrition and infections during critical illness[J]. Clin Microbio Infect, 2018, 24(1):10-15.
[18] EGI M, BELLOMO R, STACHOWSKI E, et al. Variabi-lity of blood glucose concentration and short-term morta-lity in critically ill patients[J]. Anesthesiology, 2006, 105(2):244-252.
[19] KESAVADEV J, MISRA A, SABOO B, et al. Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization[J]. Diabetes Metab Syndr, 2021, 15(1):221-227.
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